extra help

The Social Security Extra Help program is also known as Low Income Subsidy or (LIS). This is one of the best and easiest to qualify programs available through Social Security. If you haven’t already, I’m going to walk you through the program and application process to make sure you are receiving all of the benefits that you are entitled to.

What Is The Extra Help Program?

LIS, also known a Extra Help is a federal subsidy program that helps low income Medicare eligible consumers pay for healthcare costs associated with prescription drug costs such as premiums, annual deductibles, and copay and coinsurance costs associated with the prescription drugs. Almost 1 in 3 Medicare consumers have Low Income Subsidy!

What Are the Qualifications For Extra Help?

To qualify for extra help, you must meet the following requirements:

Have Medicare Part A and/or Part B

Reside in one of the 50 states or the District of Columbia

Meet current income and asset requirements

Your resources must be limited to $13,820 for an individual or $27,600 for a married couple living together. Resources include such things as bank accounts, stocks, and bonds. We do not count your home, car, or any life insurance policy as resources – socialsecurity.gov

Your annual income must be limited to $18,090 for an individual or $24,360 for a married couple living together. Even if your annual income is higher, you still may be able to get some help. Some examples where you may have higher income and still qualify for Extra Help include if you or your spouse: —Support other family members who live with you; —Have earnings from work; or —Live in Alaska or Hawaii. – socialsecurity.gov

What Are the Levels of Extra Help?

Your level of LIS is determined by your qualifications. You will automatically qualify for extra help if you are a full benefit dual eligible consumer, if you receive Supplemental Security Income (SSI) benefits, or if you are a partial dual eligible consumer meaning you belong to a Medicare Savings program. There are 4 levels of LIS that you can qualify for which will determine the benefits that you will receive:

Level 4 LIS – Not eligible for Medicaid

Reduced Deductible

Member pays 15% or less for each drug and low flat copay upon reaching catastrophic coverage level

Varying premium subsidy of 0%, 25%, 50%, 75%, or 100%

Level 1 LIS – May be eligible for Medicaid

No deductible

Member pays low flat copay for each drug and 0 copay upon reaching catastrophic coverage level.

100% premium subsidy

Level 2 LIS – Must be eligible for Medicaid

No deductible

Member pays lowest flat copay for each drug and 0 copay upon reaching catastrophic coverage level.

How Do I Apply for Extra Help?

There are several way that you can apply for extra help. I’ll list them in the order of best to worst:

Apply online at socialsecurity.gov. Click on the link to go directly to the application process! This is the fastest and easiest way to apply.

Apply over the phone by calling 800-772-1213. This process will require some patience as you will likely be forced into an automatic phone system asking you for a bunch of information. In many cases you can bypass the auto system by saying “representative” 3 or more time in a row when it asks you something.

Finally, you can simply go to you local Social Security office and apply in person. Make sure you bring all possible identification, and pack a lunch because you’ll likely be there most of the day!

All Good Things Must Come to an End

Congratulations! You’ve successfully applied and been approved for extra help! Now you can sit back, relax, and do nothing! Not exactly! Approval is not a lifetime guarantee. Here is how the process works once you’ve been approved:

A form must be completed and returned within 30 days. Extra Help is terminated the following January if it is not returned.

SSA reviews are done each year, usually at the end of August. Any changes take effect the following January. Changes include:

No change in the amount of Extra Help

An increase in the amount

A decrease in the amount

Termination of Extra Help

There you have it! An all inclusive guide to extra help that explains what it is, tells you if you qualify, gives you the best way to apply, and even explains how to keep it. If you haven’t do so already, get started now!